Complementary feeding and maternal responsiveness in 8-month-old infants

In many Western countries, infants are traditionally introduced to solid foods through spoon-fed pureed foods (parent-led weaning [PLW]), but an alternative approach known as "baby-led weaning" (BLW) has become increasingly popular. With BLW, children participate in family meals and, when they show interest, caregivers provide food that they can eat independently. BLW is not recommended by the WHO Guidelines on Complementary Feeding; however, these guidelines advocate “responsive feeding”, i.e., feeding in response to the child’s hunger and satiation. Responsiveness to feeding cues is central to the hypothesis that a mismatch between a child's internal state and the caregiver's behavior may alter self-regulation in food consumption and increase the risk of being overweight. Responsive feeding has important implications beyond eating behaviour, as feeding cues are among those infant cues that promote the development of a secure attachment with the caregiver. We investigated the relationship between the complementary feeding method and maternal responsiveness to infant feeding cues in 159 Italian typically-developing 8-month-old infants. Mothers reported the complementary feeding method used (PLW, BLW, or mixed), and provided demographic information. We recorded one meal for each child during a videocall and then coded information including the type of food consumed (puree food, finger food or mix) and the proportion of time the infant self-fed. To rate the maternal responsiveness to infant hunger and satiety cues, we scored the videos using the Responsiveness to Child Feeding Cues Scale (Hodges et al., 2013). Maternal responsiveness to infant receptiveness and fullness cues were significantly correlated (r = .270, p = .001), but mothers were more responsive to infants’ receptiveness than fullness cues (t157 = 9.138, p < .001). Multiple linear regressions tested whether gender, siblings, maternal education, proportion of self-feeding, exclusive breastmilk, and weaning age were related to responsiveness. For responsiveness to receptiveness the regression was not significant (R2 =.063, F6,142 = 1.594, p = .153). For responsiveness to fullness the regression was significant (R2 =.121, F6,143 = 3.281, p = .005); maternal education was negatively related to the dependent variable (β = -.220, p = .007), whereas proportion of self-feeding was positively related to it (β = .232, p = .005). Responsiveness to feeding cues did not significantly differ depending on complementary feeding method (receptiveness: F2,153= .712, p = .492; fullness: F2,154 = .291, p = .748) or food type (receptiveness: F2,155= .921, p = .400; fullness: F2,156= .209, p = .812). Our results parallel Hodges et al.’s (2013) findings, indicating higher maternal responsiveness to infant receptiveness than fullness cues, possibly due to an evolutionarily ancient drive to protect infants against hunger. We also provide, for the first time in a sample of young infants of the same age, observational evidence that infant self-feeding relates to higher level of maternal responsiveness to fullness cues. These findings suggest that a complementary feeding approach that emphasizes independent feeding may promote more infant-centered maternal responses at the end of the meal, with potential implications for better infant self-regulation and possibly socio-emotional development beyond the weaning period.